Monday, March 7, 2011

Four Stages of Trauma Recovery

For those who judge how I have handled my trauma...

Recovering from Trauma

Not everyone who endures a traumatic experience is scarred by it; the human psyche has a tremendous capacity for recovery and even growth. Recovering from a traumatic experience requires that the painful emotions be thoroughly processed. Trauma feelings can not be repressed or forgotten. If they are not dealt with directly, the distressing feelings and troubling events replay over and over in the course of a lifetime, creating a condition known as post-traumatic stress disorder.

Whatever inner resources people need to mobilize for recovery, they still can not accomplish the task alone. Depression and trauma are disconnective disorders. They do not improve in isolation. To fix them you have to be connected to others.

Direct experience with disasters ranging from war and terrorism to hurricanes and earthquakes has taught me that there are four basic stages in recovering from a profound stress. Progression through all four stages is essential to recovery.

Stage One: Circuit-breaking
If you overload an electrical system with too much energy and too much stimulation, the circuit breaker activates and shuts everything down. The human nervous system is also an electrical system, and when it is overloaded with too much stimulation and too much danger, as in trauma, it also shuts down to just basics. People describe it as feeling numb, in shock or dead inside.

The juice turns off. Intellectually, you lose from 50 to 90 percent of brain capacity, which is why you should never make a decision when you're "in the trauma zone." Emotionally you don't feel anything. Spiritually you're disconnected, you have a spiritual crisis or it doesn't mean anything to you at all.

Physically all your systems shut down and you run on basics. What is so intriguing is that physical symptoms that were previously prominent often disappear during this time. Back pain, migraines, arthritis, even acne often clear up. Then, when recovery from trauma is complete, the physical symptoms return.

When the system starts to recover and can handle a bit more stimulation and energy—and the human system is destined to try to recover, to seek equilibrium—feelings begin to return.

Stage Two: Return of Feelings
Most people have not experienced so much primary trauma that they must see a professional counselor; they can work through their feelings by involving the people they are close to. They do it by telling their story—a hundred times. They need to talk talk talk, recount the gory details. That is the means by which they begin to dispel the feelings of distress attached to their memories.

The more that feelings can be encouraged, the better. The more you feel the more you heal.

The expression of feelings can take many forms. For most people it may be easiest to talk. But others may need to write. Or draw. However they tell their stories, the rest of us have an obligation to listen.

It is often helpful to actually revisit the scene of destruction. That allows someone who has been impacted directly to emotionally experience the event and grasp the reality of it. That direct experience can stimulate the return of feeling. Visiting the site is not for everybody, however. For some it is too disturbing. Others may need the support of loved ones to revisit the scene.

There are four broad patterns of expression of feelings that people employ in response to a crisis. Call them feeling styles. Some people consistently maintain one style; others exhibit all four styles at different times.

It is important to recognize which style of emotional expression is characteristic of your response, and which patterns your loved ones display. Each one demands a different approach.

The Trickle Effect
Feelings flow in little trickles, slow but steady. Tricklers have feelings at a low or medium level most of the time.

Hit and Run Feelings
Some people hit an emotion, experience it intensely, then find it so scary they run away from it. They avoid it and may not talk about it for days, weeks or even months. Then they hit the feeling again, it blows up and they run away from it again.

Roller Coasters
Many people go up and down emotionally. They are in touch with their feelings but their feelings are all over the place. Like a roller coaster, however, they can go very quickly through the feeling stage.

Tsunamis
Emotions come in tidal waves that are so big, comprehensive and overwhelming that those who get them feel like they're going to drown. They flail about, and then the wave recedes; they discover that they're still alive and they feel better. Tsunamis usually occur because people repress their feelings of pain.

Stage Three: Constructive Action
People need to take action and make a difference even in the smallest ways. Taking action restores a sense of control and directly counteracts the sense of powerlessness that is the identifying mark of trauma.

The ways of action are many. You can write a letter to the rescue workers. You can give blood. You can make a card for those who lost loved ones. You can hang a flag if that means something to you, or donate to the Red Cross. You can feed rescue workers or collect needed supplies for them from your community. You can take in children whose families can't reach them. You can help a person who is out of control to get more grounded during the crisis.

You do whatever you can and never assume that any gesture is too small. In a situation that is overwhelming, you don't go for the big picture. You go for what is closest to you and where you can make a difference. Constructive action might be writing about the catastrophe or creating some work of art about it. It also encompasses getting back to work so that you can contribute something.

Stage Two and Stage Three go hand in hand. To go forward you feel and you act. You can't do one or the other. Acting and feeling become an engine that propels you forward.

Stage Four: Reintegration
In the wake of crisis it is possible to learn and grow at rates 100 times faster than at any other time, because there is a door of opportunity. Growth can go at warp speed in every domain of life.

You can learn much that is deep and profound. You do this by interacting and by working together on the meaning of the difficult experience. Those who have the courage to become part of the trauma tribe, to experience and share their pain, or to help them overcome their pain, also have the opportunity to share their growth.

Everyone who goes through this process ends up better, stronger, smarter, deeper, and more connected. They would say so and everyone who comes in contact with them recognizes the change. It is like having a broken bone. If it heals properly, it is stronger in the spot where it fractured than it was before the injury.

Traumatic experiences are broken bones of the soul. If you engage in the process of recovery, you get stronger. If you don't, the bones remain porous, with permanent holes inside, and you are considerably weaker.

In this stage of recovery, you reintegrate your self and your values in a new way. You incorporate meaning in your life. You integrate deeper and more authentic ways of communicating.

People at this stage may experience a new sense of the preciousness of life, a clarification of goals and renewed commitment to them, and new understanding of the value of ties to others. But to get to stage four you have to go through the first three stages.

8 comments:

Jonathan Phillips said...

this a good viewpoint, other people who have suffered any type of trauma or have loved ones who have should read this....thanks!

Unknown said...

Very interesting! Thank you. I, myself, have had a massively traumatic experience a few years ago and suffered from PTSD for years. You HAVE to talk about it. Holding it in is deadly to your soul. I have to admit, I really should have and should be seeing a therapist. Lol.

Unknown said...

You do what you have to do. Those who can relate support you. Those who have not had something traumatic occur to them are lucky - and I hope they never understand fully.

Rachel said...

I have tried exercise, chiropractors, acupuncture, a million NSAIDs, and muscle relaxants. Nothing helps except for massage and very hot baths, sometimes with Tiger Balm (tigerbalm.50webs.com/English/index.htm) applied to the lumbar region and afterwards bed rest. It helps to ease up my muscles and for getting through the pain/minor injuries that sometimes happen.

careyo459 said...

I am so proud of how you have handled this situation. You are a very beautiful person and show true strength. This article shows me that you are doing exactly what you need to do to cope with this horrific ordeal. Keep up the good work and stay in touch with those of us that love you.

amused citizen said...

Hey, Lexie. Is Step 2-b contacting Inside Edition? Also, Travis has been pretty quiet for about a month. Maybe you should refriend him again.

elexis said...

How disturbing you are 'amused' by all of this. :(

CLWaltrip said...

Amused citizen, you should be ashamed of yourself. Either get educated or keep your ignorance to yourself.

I am in solidarity with you, Elexis. Your strength is evident. I am thankful that it appears no one has made you doubt your right to feel traumatized, your need to talk, to know that none of this is your fault--not even a little. Some may have tried, but they have not succeeded. Hold tight to your convictions.

As a survivor of trauma, I know it is hard to keep perspective, to stay feeling sane, to maintain your resolve in the most important, but vulnerable, truths: that talk does not get old, that your loved ones should listen (and never stop), that your trauma is real and not self-inflicted, and that you did NOTHING to deserve or invite it.

I hope you keep that resolve. Your strength is helping me keep mine.